Adjustable ventilation mask for a patient

ABSTRACT

A mask to facilitate ventilation of a patient. The mask has a face piece, an oropharyngeal airway, and an ambu bag. The oropharyngeal airway is incrementally movable to move the patient&#39;s tongue to clear the patient&#39;s oropharynx and to assist in sealing the face mask to the patient&#39;s face. A method of use is disclosed.

CROSS REFERENCE TO RELATED APPLICATION

[0001] The present application is related to application Ser. No._______ entitled “DOUBLE BARREL VENTILATION MASK” which is being filedconcurrently herewith.

BACKGROUND OF THE INVENTION

[0002] The present invention relates to a face mask for ventilation of apatient and more particularly to a face mask which provides an improvedseal between the face mask and the patient's face.

[0003] 1. Related Art

[0004] The standard masks currently available for a rescuer oranesthetist attempt to perform the basic function of patientventilation. A patient who has become unconscious from accidentalinjury, medical reasons or medications administered requires skilled orrelatively untrained medical personnel to provide the basic function ofbreathing (i.e., ventilation). Many patients are able to be adequatelyventilated with the masks currently available; however, there are asignificant number of patients who cannot be adequately ventilated. Thisscenario will lead to anoxic brain injury and death if not quicklyaddressed. Patients must be ventilated and oxygenated by firstresponders until paramedics arrive or by hospital personnel until aphysician is available to secure the airway usually by trachealintubation. The patients at increased risk of poor mask ventilationinclude those who suffer from obesity, obstructive sleep apnea,congenital and acquired facial deformity, patients with beards, facialor airway edema, patients with excessive oral secretions, patientswithout teeth and occasionally someone who appears an “easy to maskventilate”. Endotracheal intubation can be attempted in these patients;however, this is not immediately available outside of the operatingroom. The patient's survival depends on the temporizing measure of maskventilation before tracheal intubation becomes available, and even thenthese same people are at risk to be “difficult intubations” whencompared with the general population. In addition, in many parts of thecountry where advanced life support is unavailable, endotrachealintubation is not even an option. The final step of providing a surgicalairway through an incision in the neck is again a limited option, asmost physicians are not skilled in this procedure, and most pre-hospitalpersonnel are not trained to perform this procedure. Death and braininjury are guaranteed results from obstructed airways due to inadequateventilation.

[0005] The problem that occurs in patients who are difficult to maskventilate results from inadequate facial seals despite an inflated rimand inadequate delivery of oxygen past redundant oral or pharyngealtissues which act to block oxygen flow. In an effort to correct theseproblems, medical personnel may insert a separate oropharyngeal ornasopharyngeal airway, but the rescuer must obtain an adequate facialseal in order for these to function effectively, and usually thisremains problematic, especially since the basic airway training may beremote and experience limited.

[0006] Secondly, if an adequate facial seal is obtained, the rescuermust rely on indirect currents of air passively entering theaforementioned airways from trapping between mask and face. Thislow-pressured air must not only enter the oropharyngeal ornasopharyngeal airway, but then must have enough force to pass redundantsoft tissue in the mouth or oropharynx to enter the trachea.

[0007] The applicant is aware of U.S. Pat. No. 3,056,402 to Dickinsonwhich discloses a respiratory mask having a head harness, molded rubberfore piece and pipe for oxygen which is designed for aviation use.

SUMMARY OF THE INVENTION

[0008] It is an object of the present invention to provide a mask toimprove the ability to ventilate marginally ventilated patients or toobtain ventilation and oxygenation in a patient with an obstructedairway.

[0009] It is a further object of the present invention to provide a facemask with an adjustable oropharyngeal airway which draws the mask moreclosely to the patient's face while moving the tongue anterior andimproving passage of oxygen behind the tongue and into the trachea.

[0010] In accordance with the teachings of the present invention, thereis disclosed a mask to facilitate ventilation of a patient. The patienthas a face, a chin, a nose, a mouth, a tongue and an oropharynx. Themask is mounted on the patient. A face-piece covers the mouth and noseof the patient. A ventilation port is formed on the face piece. A slotis formed in the face piece opposite the patient's mouth. A peripheralcuff is formed around the face piece, the peripheral cuff forming a sealwith the patient's face. An oropharyngeal airway is received in the slotin the face piece. The oropharyngeal airway has a first end disposed inthe oropharynx of the patient and a second end extending outwardly fromthe face piece. An adjusting means is provided for incrementally movingthe oropharyngeal airway within the slot. Adjusting the adjusting meansin a first direction moves the oropharyngeal airway outwardly disposingthe cuff of the face piece snugly on the face of the patient and pullingthe tongue of the patient anteriorly.

[0011] In further accordance with the teachings of the presentinvention, there is disclosed a mask to facilitate ventilation of apatients. The mask has a face piece having an opening therein. Anoropharyngeal airway is received in the opening in the face piece. Theoropharyngeal airway has a first end disposed in the oropharynx and asecond end extending outwardly from the face piece. Means are providedfor moving the oropharyngeal airway within the slot wherein the facepiece is fitted snugly over the face of the patient.

[0012] In another aspect, there is disclosed a method of ventilating apatient having a face, a chin, a nose, a mouth, a tongue and anoropharynx. A face mask is provided having a face piece. The face piecehas a ventilation port and a slot formed therein. A peripheral cuff isformed around the face piece. An oropharyngeal airway is received in theslot in the face piece. An ambu bag is connected between a source ofoxygen and the ventilation port. Adjusting means are formed between theface piece and the oropharyngeal airway. The face piece is disposed overthe mouth and nose of the patient. The peripheral cuff contacts the faceof the patient. The adjusting means is adjusted to move theoropharyngeal airway outwardly from the face piece, pulling thepatient's tongue anteriorly and disposing the cuff of the face piecesnugly on the face of the patient. The ambu bag is pumped to administeroxygen through the face piece to the patient.

[0013] These and other objects of the present invention will becomeapparent from a reading of the following specification, taken inconjunction with the enclosed drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

[0014]FIG. 1 is a diagrammatic view showing the oropharyngeal airwaydisposed in the mouth of the patient.

[0015]FIG. 2 is a perspective view of the face piece of the presentinvention.

[0016]FIG. 2A is a perspective view of the face piece of the presentinvention with means for attaching a strap.

[0017]FIG. 3 is a side elevation view of the face piece of the presentinvention.

[0018]FIG. 3A is a side elevation view of the face piece of the presentinvention with means for attaching a strap.

[0019]FIG. 4 is a diagrammatic view showing the face mask of the presentinvention disposed on the face of the patient.

[0020] FIGS. 5-8 are a sequence of side elevation views showing use ofthe present invention.

[0021]FIG. 9 is a partial cutaway view showing a toothed wheel engagingteeth on the oropharyngeal airway.

[0022]FIG. 10 is a partial cutaway view showing a worm gear engagingworm threads on the oropharyngeal airway.

[0023]FIG. 11 is a partial cutaway view showing a friction rollerengaging the oropharyngeal airway.

[0024]FIG. 12 is a perspective view showing an adjustable length strapconnected to the face piece and disposed about the patient's head.

[0025]FIG. 13 is a cross sectional view taken across lines 13-13 of FIG.9.

DESCRIPTION OF THE PREFERRED EMBODIMENT

[0026] A patient in need of ventilation frequently is unconscious, in asupine position and the patient's tongue 10 has fallen toward the backof the neck and completely, or at least partially, blocks the airpassage. As shown in FIG. 1, an oropharyngeal airway 12 is placed in thepatient's mouth 14. Preferably, the oropharyngeal airway 12 is nothollow. The first end 16 of the oropharyngeal airway 12 extendsoutwardly from the mouth 14 and the second end 18 of the oropharyngealairway 12 is disposed into the oropharynx 20 of the patient. The secondend 18 of the oropharyngeal airway 12 is curved and engages the back ofthe tongue 10 such that moving the oropharyngeal airway 12 in adirection outwardly from the mouth 10 moves the tongue 10 in the samedirection to provide clearance in the air passage in the patient. Thiswill be further described.

[0027] A face piece 22 (FIGS. 2-3) is made of an air impermeablematerial such as rubber, plastic or treated fabric, which preferably isflexible. A ventilation port 24 is formed on the face piece 22. A slot26 is formed in the face piece 22. The slot 26 is disposed opposite fromthe patient's mouth 14 when the face piece 22 is placed on the patient'sface as will be described. The face piece 22 has a peripheral cuff 28formed thereon, the peripheral cuff 28 forming a seal with the patient'sface when the face piece 22 is placed on the patient. Preferably, theperipheral cuff 28 is padded or inflated, or has a design to form a leakresistant seal with the patient's face.

[0028] The face piece 22 has a chin portion 30 which encloses the chin32 of the patient when the face piece 22 is placed on the patient.

[0029] Referring to FIG. 4, the face mask 34 has the face piece 22, theoropharyngeal airway 12 and an ambu bag 36. The oropharyngeal airway 12is received in the slot 26 in the face piece 22 such that the first end16 of the oropharyngeal airway 12 extends outwardly from the face piece22. The face piece 22 is so oriented on the patient's face that the slot26 is opposite the patient's mouth 14 and the oropharyngeal airway 12 isreceived in the patient's mouth 14 with the second end 18 of theoropharyngeal airway 12 disposed in the oropharynx 20 of the patient.The curved second end 18 is in contact with the back of the tongue 10.The oropharyngeal airway 12 is slidable within the slot 26 in the facepiece 22. Preferably, the slot 26 forms an airtight seal with theoropharyngeal airway 12.

[0030] Preferably, the face piece 22 has at least one finger grip 38formed thereon as shown in FIGS. 2, 3 and 4. The finger grips 38 are toreceive the fingers of the person providing ventilation to the patient.Finger grips 38 formed on the chin portion 30 of the face piece 22enable the rescuer or health care professional (ambulance attendant,paramedic, nurse, physician, etc.) to hold the face mask 34 more firmlyagainst the face of the patient. In the usual practice, the rescuer ispositioned above the head of the patient and grasps the face mask withfingers under the chin 32 and the thumb on the portion of the face mask34 over the nose 40 of the patient. Finger grips 38 are also formed onthe face piece 22 where the face piece 22 is supported by the nose 40 ofthe patient. In this manner, the rescuer presses on the face mask 34improving the seal formed by the peripheral cuff 28 and simultaneouslylifting the patient's head upwardly toward the rescuer and backwardlywith respect to the patient to assist in clearing the air passage in theoropharynx 20 of the patient.

[0031] An ambu resuscitation bag 36 is connected to the ventilation port24 on the face piece 22. Oxygen is introduced into the ambu bag 36 andpumping the ambu bag 36 forces the oxygen into the air passage of thepatient. The oxygen enters both the nasal passage 42 and the oralpassage (mouth) of the patient on either side of the palate 44 as shownby the arrows in FIG. 4. A separate oropharyngeal or nasopharyngealairway can be placed to assist with effective ventilation andoxygenation.

[0032] The sliding movement of the oropharyngeal airway 12 in the slot26 in the face piece 22 is controlled by an adjusting means. In oneembodiment (FIG. 4) the intermediate portion of the oropharyngeal probe12 has a plurality of spaced apart saw teeth 46 formed thereon. A pawl48 is mounted exteriorly on the face piece 22 such that the pawl 48engages the saw teeth 46 on the oropharyngeal airway 12. Ratcheting thepawl incrementally moves the oropharyngeal airway 12 in a firstdirection outwardly through the slot 26 in the face piece 22. Thismovement of the airway 12 causes the curved second end 18 of the airway12 to fully contact the base of the patient's tongue 10 adjacent to theoropharynx and to move the tongue anteriorly toward the face mask 34 atthe front of the patient's mouth 14. In this manner the oropharynx 20 ofthe patient becomes unobstructed providing clear oral and nasal passagesfor the flow of oxygen into the patient's lungs. The ratcheting of thepawl 48 further presses the face piece 22 against the face of thepatient forming a better seal between the cuff 28 on the face piece 22and the patient's face.

[0033] The second end 18 of the oropharyngeal airway 12 may have agreater curvature more nearly “J” shaped as shown in FIG. 10. Thisconfiguration more positively engages the base of the patient's tongueand provides greater assurance that the oral passage is unobstructed.This alternate embodiment is shown on FIG. 10 for illustration only. Anyembodiment of the airway 12 may be used with any embodiment of adjustingmeans.

[0034] FIGS. 5-8 show the sequence of use of the present invention.

[0035] Alternately, the oropharyngeal airway 12 may be disposed in theslot 26 in the face piece 22 before placing the face piece 22 on theface of the patient. The oropharyngeal airway 12 is then inserted in themouth and oropharynx of the patient and the face piece 22 is slid downon the airway 12 and seated on the patient's face.

[0036] Alternately, as shown in FIG. 9, a plurality of spaced apartteeth 50 are formed on the intermediate portion of the oropharyngealairway 12. A toothed wheel 52 is attached to the face piece 22 such thatthe toothed wheel 52 engages the teeth 50 on the oropharyngeal airway 12in a rack and pinion-like manner. Preferably the teeth 50 are square orrectangular. Rotation of the toothed wheel 22 incrementally moves theoropharyngeal airway 12 to slide within the slot 26 in the face piece 22to move the tongue 10 of the patient and to assist in forming a sealbetween the cuff 28 on the face piece 22 and the patient's face.

[0037] Another embodiment to effect incremental movement of theoropharyngeal airway 12 in the slot 26 in the face piece 22 is shown inFIG. 10. The intermediate portion of the oropharyngeal airway 12 hasworm threads 54 formed thereon. A worm gear 56 is attached to the facepiece 22 such that the worm gear 56 engages and cooperates with the wormthreads 54. In this manner, movement of the worm gear 56 producesmovement of the oropharyngeal airway 12.

[0038] Still another embodiment of the face mask 34 to produceincremental sliding movement of the oropharyngeal airway 12 within theslot 26 in the face piece 22 is shown in FIG. 11. A roller means 58having a gripping outer surface is connected to the face piece 22. Thegripping outer surface contacts the oropharyngeal airway 12 andfrictionally moves the airway 12 within the slot 26 in the face piece22.

[0039] Other means known to persons skilled in the art may be used toadjust the disposition of the oropharyngeal airway 12 with respect tothe face piece 22.

[0040] To further assist in sealing the face mask 34 to the patient, aplurality of spaced apart protrusions 60 are formed on the face piece22, extending outwardly therefrom (FIGS. 2A, 3A and 12). At least a pairof protrusions 60 are formed on opposite sides of the face piece 22. Atleast one strap 62 is connected between the at least one pair ofprotrusions 60 such that the at least one strap 62 is connected to oneof the protrusions 60, extends around the head of the patient and isconnected to another of the protrusions of the pair on the opposite sideof the face piece 22. There may be more than one strap 62 which isdisposed higher or lower on the patient's head in relation to the onestrap 62. The strap 62 may be an elastic band which may stretch or mayhave buckle, hook and loop fasteners or other means known to personsskilled in the art to provide an adjustable length of the strap. In thismanner, the strap provides for use with patients having a wide variationin head size.

[0041] The face piece 22 may also be formed in several sizes to providea better seal for patients having larger or smaller faces. Theoropharyngeal airway 12 has a cross section (FIG. 13) which is larger orsmaller to correspond with the size of the face piece and the patient.

[0042] The face mask of the present invention provides an improvedability to ventilate and oxygenate marginally ventilated patients toobtain ventilation on patients who cannot be ventilated by face maskswhich are presently available. The mask of the present invention has thefollowing features:

[0043] 1. New design of a chin portion of the mask with finger groovesat proximal and distal ends which allows improved facial seal,especially when the patient's head is extended.

[0044] 2. Ratchet/roller adjusted oropharyngeal airway whichobtains/improves oxygenation by lifting the tongue anteriorly off theposterior oropharynx and maintaining its position, allowing for passageof oxygen into the trachea.

[0045] 3. Same ratchet/roller adjusted oropharyngeal airway whichimproves ventilation by improved facial seal created by tension createdbetween upward oropharyngeal airway motion with concomitant downwardpressure of mask.

[0046] Obviously, many modifications may be made without departing fromthe basic spirit of the present invention. Accordingly, it will beappreciated by those skilled in the art that within the scope of theappended claims, the invention may be practiced other than has beenspecifically described herein.

What is claimed is:
 1. A mask to facilitate ventilation of a patient,the patient having a face, a chin, a nose, a mouth, a tongue and anoropharynx, the mask being mounted on the patient comprising: a facepiece covering the mouth and nose of the patient, a ventilation portformed on the face piece, a slot formed in the face piece opposite thepatient's mouth, a peripheral cuff around the face piece, the peripheralcuff forming a seal with the patient's face, an oropharyngeal airwayreceived in the slot in the face piece, the oropharyngeal airway havinga first end disposed in the oropharynx of the patient and a second endextending outwardly from the face piece, an adjusting means forincrementally moving the oropharyngeal airway within the slot, whereinadjusting the adjusting means in a first direction moves theoropharyngeal airway outwardly disposing the cuff of the face piecesnugly on the face of the patient and pulling the tongue of the patientanteriorly.
 2. The mask of claim 1, wherein the face piece further has achin position enclosing the chin of the patient.
 3. The mask of claim 1,further comprising at least one finger grip formed in the mask whereinexternal pressure is applied to the at least one finger grip to hold themask more firmly against the face of the patient.
 4. The mask of claim3, wherein at least one finger grip is formed on a chin portion of theface piece.
 5. The mask of claim 3, wherein at least one finger grip isformed on a portion of the face piece which is mounted over the nose ofthe patient.
 6. The mask of claim 1, further having at least a pair ofspaced apart protrusions extending outwardly from the face piece, atleast one strap having an adjustable length being connected between theat least one pair of protrusions, the at least one strap being disposedabout the patient's head and securing the mask to the patient's head. 7.The mask of claim 6, wherein the at least one strap is formed from anelastic material.
 8. The mask of claim 1, wherein the adjusting means isa plurality of spaced apart saw teeth formed on the oropharyngeal airwayand a pawl disposed on the face piece, the pawl engaging the teeth onthe oropharyngeal airway.
 9. The mask of claim 1, wherein theoropharyngeal airway has teeth formed thereon, a toothed wheel attachedto the face piece, the toothed wheel engaging and cooperating with theteeth on the oropharyngeal airway, thereby providing the adjusting meansfor moving the oropharyngeal airway.
 10. The mask of claim 1, furthercomprising a roller means connected to the face piece, the roller meanshaving a gripping outer surface, the gripping outer surface contactingthe oropharyngeal airway such that moving the roller means moves theoropharyngeal airway within the slot in the face piece, therebyproviding the adjusting means for moving the oropharyngeal airway. 11.The mask of claim 1, wherein the oropharyngeal airway has worm threadsformed thereon, a worm gear attached to the face piece, the worm gearengaging the worm threads on the oropharyngeal airway, thereby providingan adjusting means for moving the oropharyngeal airway.
 12. The mask ofclaim 1, wherein the first end of the oropharyngeal airway is curved andcontacts the tongue of the patient adjacent to the oropharynx.
 13. Themask of claim 1, further comprising an ambu bag connected to theventilation port wherein oxygen may be administered to the patient. 14.A mask to facilitate ventilation of a patient, the mask comprising, aface piece having an opening therein, an oropharyngeal airway receivedin the opening in the face piece, the oropharyngeal airway having afirst end disposed in the oropharynx and a second end extendingoutwardly from the face piece, means for moving the oropharyngeal airwaywithin the opening wherein the face piece is fitted snugly over the faceof the patient.
 15. A method of ventilating a patient having a face, achin, a nose, a mouth, a tongue and an oropharynx, comprising the stepsof: providing a face mask having a face piece, the face piece having aventilation port and a slot formed therein, a peripheral cuff beingformed around the face piece, an oropharyngeal airway being received inthe slot in the face piece, an ambu bag being connected between a sourceof oxygen and the ventilation port, adjusting means being formed betweenthe face piece and the oropharyngeal airway, disposing the face pieceover the mouth and nose of the patient, the peripheral cuff contactingthe face of the patient, adjusting the adjusting means to move theoropharyngeal airway outwardly from the face piece, pulling thepatient's tongue anteriorly and disposing the cuff of the face piecesnugly on the face of the patient, and pumping the amber bag toadminister oxygen through the face piece to the patient.
 16. The methodof claim 15, wherein the face piece has a chin portion, the chin portionbeing disposed over the face of the patient to enclose the chin of thepatient.